by Brian Taylor
“Signal & Noise” is a bimonthly column by Brian Taylor, AuD.
Nearly every patient fitted with hearing aids in a clinic returns for at least ten hours of additional follow-up care. Spread over the course of four or more years, these face-to-face visits with the clinician gobble up a lot of precious time, and even more troubling, do not always result in favorable patient outcomes.
To support this assertion, readers are encouraged to find a recent vein of research suggesting the needs of adult hearing aid owners are not being adequately addressed. In one study, 90% of hearing aid owners demonstrated difficulty with basic hearing aid management tasks, such as inserting the device into the ear or properly cleaning it. Another study, published in 2013, reported that almost one-half of hearing aid owners did not receive enough practical help about their hearing aid use. Obviously, insufficient training and support can lead to poor outcomes and non-use of hearing aids. But just how widespread of a problem this poses is a question that warrants further analysis.
Rebecca Bennett of the Ear Sciences Centre at The University of Western Australia and her colleagues have addressed these apparent gaps in the informational and training needs of adults fitted with hearing aids. Using a research method called concept mapping, an approach previously used to study help seeking behaviors in adults with hearing loss, Bennett and her colleagues evaluated the opinions of both hearing aid owners and clinicians about their knowledge, skills and tasks required to use, handle, care and maintain hearing aids. Described by the researchers as hearing aid management skills, the main objective of their work is to better understand the key skills and attributes of adult hearing aid users so that clinicians can deliver a better quality of care to individuals after they have been fitted with hearing aids.
Hearing Aid Management
In a series of studies published in the American Journal of Audiology and Ear & Hearing, Bennett et al identified more than 100 unique descriptors of the hearing aid management process that could be broken down into six separate concepts that influenced hearing aid use and quality of follow-up care:
- Working with your clinician
- Communication strategies
- Learning to come to terms with hearing aids
- Hearing aid maintenance and repairs
- Daily hearing aid use
- Advanced hearing aid knowledge.
Items 1-3 were classified as person-centered attributes, while items 4-6 were classified by the researchers are device-centered attributes. Hearing aid owners (24 of them participated in the study) indicated that all six concepts were similarly important, whereas clinicians (22 participated in the study) indicated that advanced hearing aid knowledge was less important to long term success of the patient than the other five concepts.
Bennett shared with HHTM,
“One of my burning questions after completing these concept mapping studies was ‘how common are these problems?’ To investigate this question, we developed a survey listing the hearing aid problems identified in the first study. This survey is called the Hearing Aid Problems Survey or HAPS. We have surveyed over 500 adult hearing aid owners from seven different clinics around Australia. I am still in the process of writing this manuscript, but preliminary results show that 91% of participants reported experiencing at least one of the problems listed on the HAPS. Participants most commonly reported problems with hearing aid discomfort, difficulty hearing in noise and amplification of unwanted sounds. Participants reported these problems persisting, despite seeking help from clinicians in approximately 50% of the cases.”
Bennett went on to say, “Despite the on-going support offered to clients after they acquire hearing aids, they are often hesitant to seek help from their clinician, and instead engage in a myriad of helpful and unhelpful behaviors in response to problems that arise with their hearing aids. Previous positive and negative experiences with the clinic, clinician and significant other influenced these actions, highlighting the influential role of these individuals’ in the success of the rehabilitation process. This data suggests that clinicians could improve hearing aid problem resolution by providing technical and emotional support, including to significant others by promoting client empowerment and self-management.”
**Stay tuned next week for Part 2
Brian Taylor, AuD, Brian Taylor is the director of clinical audiology for the Fuel Medical Group. He also serves as the editor of Audiology Practices, the quarterly journal of the Academy of Doctors of Audiology, and editor-in-chief of Hearing News Watch for HHTM. Brian has held a variety of positions within the industry, including stints with Amplifon (1999-2008) and Unitron (2008-2015). Dr. Taylor has more than 25 years of clinical, teaching and practice management experience. He has written and edited six textbooks, including the third edition of Audiology Practice Management (Thieme Press) which will be published in 2018. He lives in Minneapolis, MN and can be reached at firstname.lastname@example.org
*feature image courtesy of Cambridge in Color